<p>SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE 1 OF OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30 2. CONTRACT NO. 3. AWARD/EFFECTIVE 4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE DATE</p><p>7. FOR SOLICITATION a. NAME b. TELEPHONE NUMBER(No collect 8. OFFER DUE DATE/ LOCAL calls) TIME INFORMATION CALL:</p><p>9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE:____ % FOR:</p><p>SMALL BUSINESS WOMEN-OWNED SMALL BUSINESS</p><p>HUBZONE SMALL (WOSB) ELLIGIBLE UNDER THE WOMEN-OWNED BUSINESS SMALL BUSINESS PROGRAM NAICS:</p><p>SERVICE-DISABLED EDWOSB VETERAN-OWNED SIZE STANDARD: SMALL BUSINESS 8 (A)</p><p>13b. RATING 11. DELIVERY FOR FOB DESTINAT- 12. DISCOUNT TERMS 13a. THIS CONTRACT IS A TION UNLESS BLOCK IS RATED ORDER UNDER MARKED DPAS (15 CFR 700) 14. METHOD OF SOLICITATION</p><p>SEE SCHEDULE RFQ IFB RFP 15. DELIVER TO CODE 16. ADMINISTERED BY CODE</p><p>17a. CONTRACTOR/ CODE FACILITY 18a. PAYMENT WILL BE MADE BY CODE OFFERER CODE</p><p>TELEPHONE NO.</p><p>18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK 17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER BELOW IS CHECKED SEE ADDENDUM 19. 20. 21. 22. 23. 24. ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT</p><p>(Use Reverse and/or Attach Additional Sheets as Necessary) 25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)</p><p>27a.SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED</p><p>27b.CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED</p><p>28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ____ COPIES 29. AWARD OF CONTRACT: REF. ______OFFER DATED TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS ______. YOUR OFFER ON SOLICITATION (BLOCK 5), INCLUDING ANY SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN, IS ACCEPTED AS TO SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED HEREIN. ITEMS:</p><p>30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)</p><p>30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED</p><p>AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 1449 (REV. 02/2012) PREVIOUS EDITION IS NOT USABLE Computer Generated Prescribed by GSA - FAR (48 CFR) 53.212 19. 20. 21. 22. 23. 24. ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT</p><p>32a. QUANTITY IN COLUMN 21 HAS BEEN</p><p>RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______</p><p>32b. SIGNATURE OF AUTHORIZED GOVERNMENT 32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE REPRESENTATIVE</p><p>32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE</p><p>32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE</p><p>33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED 36. PAYMENT 37. CHECK NUMBER CORRECT FOR PARTIAL FINAL COMPLETE PARTIAL FINAL 38. S/R ACCOUNT NO. 39. S/R VOUCHER NO. 40. PAID BY</p><p>41.a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print) 41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41C. DATE 42b. RECEIVED AT (Location)</p><p>42c. DATE REC’D (YY/MM/DD) 42d. TOTAL CONTAINERS</p><p>STANDARD FORM 1449 (REV. 2/2012) BACK</p>